Dear Covid Policies...
It's not me. It's definitely you.
Dr. Eliza Holland, of #UrgencyOfNormal is back talking about some personal actions she took after the Cochrane mask review was released late last month.
Also, make sure to read her previous writing: Camp Covid, about the personal costs of last summer’s overly restrictive summer camp policies and “Immunity Debt: When the Bill Comes Due,” where she explained why we saw greater circulation of respiratory viruses this winter.
Here’s Eliza:
I am in a mood.
My hospital still requires masking in all patient areas. I am a pediatric hospitalist so it really bothers me to have to see a patient and their family, who are already scared and stressed, with half of my face covered. Pre-COVID, we only masked when seeing patients with respiratory symptoms. I could make a funny face for the patient from the doorway. I could talk to parents, bare-faced, outside of the room. No longer.
The last three years have been tough but there does seem to be light at the end of the tunnel. Schools are open and staying open. Head Start stopped mandating masks for preschoolers. Unvaccinated NYC parents will finally be let back into the school buildings. Many European countries are treating COVID like the endemic respiratory virus it now is. Yet there are some remaining sticking points, like having to mask in the hospital and continued COVID vaccine mandates for children to participate in extracurricular activities. These are not harmless policies. It is becoming increasingly harder to tolerate them in the absence of good supporting evidence.
Today was my tipping point. I wrote the following to our hospital epidemiologist:
“Now that we seem to be on the other side of our winter respiratory season and there is a new Cochrane review restating that community masking does not impact viral spread, I am curious as to when the hospital will move back to only masking for respiratory patients?
It has been almost three years since my patients and their families have seen my face and my full range of facial expressions. As a pediatrician, masking severely impacts my ability to form a true bond with my patients. A silly face or a smile can go a long way towards easing children's fears about being sick. There is evidence that masking impairs the reading of emotions across all ages but more so in younger children.
Multiple European countries are now treating COVID as an endemic respiratory virus (ie Norway). There is great community protection from both vaccination and prior infections. While patients are still hospitalized with COVID, there are fewer who are critically ill. What metrics are you using to determine continued masking?”
I then proceeded to send an email to a connection at the American Camping Association:
“I wanted to follow up on our conversation from the fall about masking to prevent viral illnesses. There was just another Cochrane review published that reaffirmed the findings from 2019 - masking does not appear to impact the spread of viral illnesses. Here is a great interview with one of the authors:
In addition, multiple European countries have moved towards treating COVID like other viral illnesses. You can see the recommendations from Norway here. I think we can agree that flu and norovirus were much worse for [our camp] than COVID would have been.
I know that camps are starting to form their policies with guidance from the ACA. I am already hearing that some summer camps are requiring COVID vaccination to attend, regardless of prior infection. There are great studies showing that prior infection provides protection that is equal to or better than vaccination: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00801-5/fulltext#.Y9AYDSUCsh0.twitter.
Based on current pediatric vaccination rates, mandating 2 shots would exclude 68% of 5-11 year old and 42% of 12-17 year olds (https://www.aap.org/en/pages/2019-novel-coronavirus-COVID-19-infections/children-and-COVID-19-vaccination-trends/#:~:text=Child vaccination rates vary widely,41% receiving their first dose.&text=About 17.5 million children 5,first COVID-19 vaccine dose).
In addition, there is a very real concern about heart inflammation following vaccination, especially in young men (see the slide at the end from the CDC).
Camp continues to be vitally important as our children find their way back to normalcy.
I just gave a Grand Rounds about the impact of COVID migration measures on children -
Camps absolutely have a role to play in this post-pandemic period.”
The fight for rational and evidenced-based policies continues…
Eliza Holland, MD is a pediatric hospitalist in Charlottesville, Virginia. She is a member of Urgency of Normal, a collaborative group of doctors, scientists, teachers, and parents advocating for children’s well being and an urgent return to fully normal life and schooling. Follow her at @etholland71.
Thank you Dr. Holland for continuing to speak out on this! Seeing faces is so important to our social connectedness. I will continue to do my part speaking out when I can as well. I may even use some of your stats to share, we need more organizations to step up and speak out!